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2014 ; 2014
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Salt-losing nephropathy in hypothyroidism
#MMPMID24850556
Bautista AA
; Duya JE
; Sandoval MA
BMJ Case Rep
2014[May]; 2014
(ä): ä PMID24850556
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A 35-year-old man presented with recurrent lower extremity weakness associated
with polyuria later progressing to generalised weakness with difficulty in
breathing. The patient was hypotensive and dry, with normal thyroid and chest
examination, weak lower extremity and carpopedal spasm. Workup revealed
hypokalaemia, hyponatraemia, hypocalcaemia, hypomagnesaemia, hypochloraemia and
hypophosphataemia. Arterial blood gas showed respiratory alkalosis with good
oxygenation. Twenty-four-hour urine collection showed normal volume with
electrolyte wasting. Thyroid function test revealed overt hypothyroidism with
negative antithyroid peroxidase. The patient was well after treatment with
levothyroxine, volume and electrolyte replacement and was discharged. Thyroid
hormones are related to the expression of the Na-K-ATPase, Na-Pi cotransporter,
Mg-ATPase and Na-Ca exchanger pumps in the renal tubules. Sodium, potassium,
phosphate, calcium, magnesium and water losses result from decreased expression
of these pumps.